Revista médica de Chile
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Revista médica de Chile · Jul 2012
[Phenotype and genotype of thiopurine methyltransferase in Chilean individuals].
Thiopurines (azathioprine and 6-mercaptopurine) are highly effective medications but with potential adverse effects. Thiopurine methyltransferase (TMPT) is the key enzyme in their pharmacokinetics and is genetically regulated. A low activity of TPMT is associated with myelotoxicity. The genotype and enzyme activity can vary by ethnicity. ⋯ Less than 10% of a Chilean population sample has a low enzymatic activity or allelic variants in the TPMT gene, supporting the use of thiopurines according to international recommendations.
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Revista médica de Chile · Jun 2012
Review[Description of clinical thinking by the dual-process theory].
Clinical thinking is a very complex process that can be described by the dual-process theory, it has an intuitive part (that recognizes patterns) and an analytical part (that tests hypotheses). It is vulnerable to cognitive bias that professionals must be aware of, to minimize diagnostic errors.
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Revista médica de Chile · Jun 2012
Case ReportsReversible cardiotoxicity in a 54-year-old woman treated with trastuzumab.
We report a 54-year-old woman with an stage IIA (T2N0M0) RE and RP negative and HER2-positive ductal invasive breast cancer who developed a reversible cardiotoxicity associated with chemotherapy. After surgery, she received four cycles of doxorubicin and cyclophosfamide. Later, she used paclitaxel and trastuzumab. ⋯ Systolic function of the left ventricle was normal before the initial dosis of trastuzumab, but significantly worsened following the beginning of drug administration. Moreover, a clear improvement of heart function was observed soon after the daily dose of trastuzumab was reduced. Better knowledge of risk factors for cardiotoxicity related to chemotherapy, and longstanding surveillance with serial echocardiograms can avoid more severe cardiotoxicity by chemotherapy.
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Revista médica de Chile · May 2012
[C-Reactive protein levels in patients with chronic obstructive pulmonary disease].
Patients with chronic obstructive pulmonary disease (COPD) have elevated serum levels of ultrasensitive C reactive protein (CRPus). This raise may be related directly to COPD and its associated systemic inflammation or secondary to other factors such as smoking status, disease severity, acute exacerbations, or associated complications. ⋯ CRPus is elevated in COPD patients, independent of smoking status. It is weakly associated with fat mass, arterial oxygen tension and frequency of exacerbations.
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Revista médica de Chile · Apr 2012
Case Reports[Spurious hypoxemia due to hyperleukocytosis. Report of one case].
Arterial gasometry is considered the gold standard for establishing a diagnosis of respiratory failure of any etiology. However, there are some circumstances in which it loses specificity, making necessary to consider other tests such as pulse oximetry to adequately determine hypoxemia. ⋯ Chronic myeloid leukemia was diagnosed and treatment with hydroxyurea was initiated, achieving normalization in the arterial gases in accordance with the fall of the white cell count. Interpretation of laboratory findings according to the general clinical context of the patient allowed to suspect a spurious hypoxemia, saving the patient from unnecessary and risky interventions.